Relationships and Synergistic Effects of Body Mass Index and Blood Glucose Marker on the Ankle-Brachial Index in Adult With Type 2 Diabetes Mellitus: A Cross-Sectional Study
Wang W.-J., Fadlilah S., Sumarni S., Nurrahma H.A., Tsai J.R., Tsai H.T.
Abstract
This study aimed to identify the independent and synergistic effects of body mass index, fasting blood glucose, and hemoglobin A1c on ankle-brachial index in type 2 diabetes mellitus. This cross-sectional study involved 1096 participants who were measured using questionnaires, a digital scale, and a height measurement device. Blood marker was examined using fasting venous blood. The ankle-brachial index was measured using Doppler ultrasound. A multinomial logistic regression was applied for adjusting confounders. Participants who were obese significantly increased 2.12- and 1.86-fold risk of a low and a high ankle-brachial index (p < 0.05), respectively. Participants with abnormal fasting blood glucose significantly increased 1.79- and 2.05-fold risk of a low and a high ankle-brachial index (p < 0.05). Participants with hemoglobin A1c > 6.5% significantly increased 1.71- and 1.76-fold risk of a low and a high ankle-brachial index (p < 0.05), respectively. Participants with abnormalities for all three indices synergistically increased 12.31- and 5.31-fold risk of a low and a high ankle-brachial index (p < 0.001), respectively. Abnormal body mass index, fasting blood glucose, and hemoglobin A1c readings significantly, independently, and synergistically increased the risk of an abnormal ankle-brachial index.
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